| Literature DB >> 36118121 |
Han Wu1,2, Senhao Zhang1,2, Benkun Bao1,2, Jiuqiang Li1,2, Yingying Zhang2, Donghai Qiu2, Hongbo Yang1,2.
Abstract
Automated electrocardiogram classification techniques play an important role in assisting physicians in diagnosing arrhythmia. Among these, the automatic classification of single-lead heartbeats has received wider attention due to the urgent need for portable ECG monitoring devices. Although many heartbeat classification studies performed well in intrapatient assessment, they do not perform as well in interpatient assessment. In particular, for supraventricular ectopic heartbeats (S), most models do not classify them well. To solve these challenges, this article provides an automated arrhythmia classification algorithm. There are three key components of the algorithm. First, a new heartbeat segmentation method is used, which improves the algorithm's capacity to classify S substantially. Second, to overcome the problems created by data imbalance, a combination of traditional sampling and focal loss is applied. Finally, using the interpatient evaluation paradigm, a deep convolutional neural network ensemble classifier is built to perform classification validation. The experimental results show that the overall accuracy of the method is 91.89%, the sensitivity is 85.37%, the positive productivity is 59.51%, and the specificity is 93.15%. In particular, for the supraventricular ectopic heartbeat(s), the method achieved a sensitivity of 80.23%, a positivity of 49.40%, and a specificity of 96.85%, exceeding most existing studies. Even without any manually extracted features or heartbeat preprocessing, the technique achieved high classification performance in the interpatient assessment paradigm.Entities:
Mesh:
Year: 2022 PMID: 36118121 PMCID: PMC9481402 DOI: 10.1155/2022/9370517
Source DB: PubMed Journal: J Healthc Eng ISSN: 2040-2295 Impact factor: 3.822
Figure 1Overall system structure diagram.
AAMI classification of heartbeat types.
| Class | Symbol | Members |
|---|---|---|
| Normal |
| Normal beat left bundle branch block beat right bundle branch block beat atrial escape beat nodal (junctional) escape beat |
| Supraventricular ectopic beat | SVEB ( | Atrial premature beat aberrated atrial premature beat nodal (junctional) premature beat supraventricular premature beat |
| Ventricular ectopic beat | VEB ( | Premature ventricular contraction ventricular escape beat |
| Fusion beat |
| Fusion of ventricular and normal beat |
| Unknown beat |
| Paced beat fusion of paced and normal beat unclassifiable beat |
Using interpatient division of training set DS1 and test set DS2.
| Dataset | Patient numbers in the MIT-BIH arrhythmia database |
|---|---|
| DS1 | 101, 106, 108, 109, 112, 114, 115, 116, 118, 119, 122, 124, 201, 203, 205, 207, 208, 209, 215, 220, 223, 230 |
| DS2 | 100, 103, 105, 111, 113, 117, 121, 123, 200, 202, 210, 212, 213, 214, 219, 221, 222, 228, 231, 232, 233, 234 |
Heartbeat segmentation length and S sensitivity for different methods.
| Work | Length of heartbeat | Sen (%) of S | Manually extracted features |
|---|---|---|---|
| Garcia (2017) | 270 | 61.96 | No |
| Takalo-mattila (2018) | 130 | 62.49 | No |
| Jinghao Niu (2020) | 256 | 77.35/38.7 | Yes/No |
| Haojie Zhang (2021) | 256 | 88.24/8.06 | Yes/No |
Figure 2Diagram of the heartbeat segmentation strategy. (a) The traditional heartbeat segmentation strategy. (b) The heartbeat segmentation strategy proposed in this article. (c)(i) N by the traditional heartbeat segmentation strategy. c(ii) N by the segmentation strategy in this article. c(iii) S by the traditional heartbeat segmentation strategy. c(iv) S by the segmentation strategy in this article.
Proportion of each class of heartbeats.
| Segment |
|
|
|
|
|
|---|---|---|---|---|---|
| DS1 | 45824 | 943 | 3785 | 414 | 8 |
| DS2 | 44215 | 1836 | 3219 | 388 | 7 |
Figure 3Overall structure of the classification algorithm.
Figure 4Network structure of the base classifier.
Performance metrics of six base classifiers and ensemble model
| Work | Acc (%) | +P (%) | Sen (%) | Spe (%) |
|---|---|---|---|---|
| #1 | 88.71 | 49.03 | 77.66 | 90.68 |
| #2 | 88.18 | 47.66 | 83.61 | 89.37 |
| #3 | 88.60 | 48.81 | 88.36 | 89.78 |
| #4 | 86.92 | 44.58 | 85.64 | 87.91 |
| #5 | 89.80 | 52.36 | 84.96 | 91.23 |
| #6 | 83.54 | 38.14 | 84.92 | 83.91 |
| Average | 87.63 | 46.76 | 84.19 | 88.81 |
| Result | 91.89 | 59.51 | 85.37 | 93.15 |
Confusion matrix of the ensemble classifier.
| Predicted label | ||||||
|---|---|---|---|---|---|---|
|
|
|
|
|
| ||
| True label |
| 41186 | 1427 | 535 | 1067 | 0 |
|
| 317 | 1473 | 42 | 4 | 0 | |
|
| 133 | 68 | 2929 | 89 | 0 | |
|
| 310 | 14 | 15 | 49 | 0 | |
|
| 3 | 0 | 4 | 0 | 0 | |
Classification performance results of our method and 6 advanced methods.
| Work | Acc | Class (N) | Class (S) | Class (V) | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Sen (%) | +P (%) | Spe (%) | Sen (%) | +P (%) | Spe (%) | Sen (%) | +P (%) | Spe (%) | ||
| DeChazal (2004) | 85.88 | 99.16 | 86.86 | 94.00 | 38.53 | 75.94 | 95.35 | 81.59 | 77.74 | 98.78 |
| Garcia (2017) | 92.38 | 93.99 | 97.95 | 82.55 | 61.96 | 52.96 | 97.89 | 87.34 | 59.44 | 95.91 |
| Takalo-mattila (2018) | 89.91 | 91.89 | 97.00 | 76.83 | 62.49 | 55.86 | 98.11 | 89.23 | 50.85 | 94.02 |
| Sellami (2019) | 88.34 | 88.52 | 98.8 | 91.3 | 82.04 | 30.44 | 92.8 | 92.05 | 72.13 | 97.54 |
| Jinghao Niu (2020) | 95.87 | 98.28 | 97.39 | 78.69 | 77.35 | 73.29 | 98.92 | 85.08 | 91.75 | 99.47 |
| Yuanlu Li (2021) | 88.99 | 94.54 | 93.33 | 80.8 | 35.22 | 65.88 | 98.83 | 88.35 | 79.86 | 94.92 |
| Our methods | 91.89 | 93.15 | 98.18 | 86.00 | 80.23 | 49.40 | 96.85 | 90.99 | 83.09 | 98.72 |
Overall model performance metrics for our method and 6 advanced methods.
| Acc (%) | +P (%) | Sen (%) | Spe (%) | |
|---|---|---|---|---|
| DeChazal (2004) | 85.88 | 42.21 | 92.85 | 86.86 |
| Garcia (2017) | 92.38 | 59.36 | 81.73 | 93.99 |
| Takalo-mattila (2018) | 89.91 | 52.86 | 76.18 | 91.89 |
| Sellami (2019) | 88.34 | 48.25 | 90.90 | 88.51 |
| Jinghao Niu (2020) | 95.87 | 84.55 | 78.18 | 98.28 |
| Yuanlu Li (2021) | 88.99 | 56.82 | 52.10 | 94.75 |
| Our methods | 91.89 | 59.51 | 85.37 | 93.15 |
Ablation studies on our proposed model.
| Work | Acc (%) | Class (N) | Class (S) | Class (V) | Class (F) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sen (%) | +P (%) | Spe (%) | Sen (%) | +P (%) | Spe (%) | Sen (%) | +P (%) | Spe (%) | Sen (%) | +P (%) | Spe (%) | ||
| Signal-256 + focal loss + Ensemble | 89.52 | 93.63 | 95.39 | 63.25 | 16.34 | 14.60 | 96.33 | 85.15 | 77.32 | 98.27 | 5.41 | 3.17 | 98.70 |
| Signal-508 + ensemble | 88.34 | 93.62 | 97.66 | 81.80 | 61.60 | 40.79 | 96.57 | 89.00 | 84.94 | 98.91 | 4.90 | 1.67 | 97.74 |
| Signal-508 + focal loss | 88.18 | 89.37 | 97.92 | 84.61 | 71.62 | 33.87 | 94.63 | 90.71 | 69.81 | 97.28 | 11.86 | 3.69 | 97.56 |
| Signal-508 + focal loss + ensemble | 91.89 | 93.15 | 98.18 | 86.00 | 80.23 | 49.40 | 96.85 | 90.99 | 83.09 | 98.72 | 12.63 | 4.05 | 97.65 |